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脊髓麻醉下剖宫产患者静脉注射酮咯酸与哌替啶对术后寒战和疼痛的超前镇痛效果比较:一项前瞻性、随机、双盲研究。

Comparison of preemptive effect of intravenous ketorolac versus meperidine on postoperative shivering and pain  in patients undergoing cesarean section under spinal anesthesia: A prospective, randomized, double-blind study.

作者信息

Khezri Marzieh Beigom, Mosallaei Maryam Al-Sadat, Ebtehaj Mehdi, Mohammadi Navid

机构信息

Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.

Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Caspian J Intern Med. 2018 Spring;9(2):151-157. doi: 10.22088/cjim.9.2.151.

Abstract

BACKGROUND

Pain and shivering are two unpleasant problems in postoperative period. Various techniques are used to alleviate the postoperative shivering and pain. We compared the preemptive prescription of a single dose of intravenous meperidine and ketorolac on postoperative pain and shivering in patients undergoing cesarean section with spinal anesthesia.

METHODS

One hundred and fifty patients who were scheduled for elective cesarean section under spinal anesthesia were randomly allocated to one of three study groups to receive intravenous ketorolac (group K), meperidine (group M) or normal saline (group P). Time to first analgesic request, analgesic requirement in the first 24 hours after surgery, body tympanic temperature, hemodynamic variables and incidence of shivering were assessed as outcome variables.

RESULTS

There was no significant difference between meperidine and ketorolac groups in terms of prevalence of shivering, although both groups were different from the placebo group (p<0.04). The mean time to first analgesic request was longer in group k (3.8±1.4) and groups M (3.3±1.2) than in group P (2.1±0.8) hours (p<0.001).

CONCLUSIONS

The preemptive prescription of a single dose of intravenous meperidine and ketorolac can provide a satisfying analgesia immediately after surgery and decrease shivering prevalence without any serious side effects.

摘要

背景

疼痛和寒战是术后两个令人不适的问题。人们采用了各种技术来减轻术后寒战和疼痛。我们比较了单次静脉注射哌替啶和酮咯酸对腰麻下行剖宫产手术患者术后疼痛和寒战的超前镇痛效果。

方法

150例计划在腰麻下进行择期剖宫产手术的患者被随机分为三个研究组之一,分别接受静脉注射酮咯酸(K组)、哌替啶(M组)或生理盐水(P组)。将首次要求镇痛的时间、术后24小时内的镇痛需求、体温、血流动力学变量和寒战发生率作为观察指标进行评估。

结果

哌替啶组和酮咯酸组在寒战发生率方面无显著差异,尽管这两组与安慰剂组均有差异(p<0.04)。K组(3.8±1.4)和M组(3.3±1.2)首次要求镇痛的平均时间比P组(2.1±0.8)长(p<0.001)。

结论

单次静脉注射哌替啶和酮咯酸的超前镇痛可在术后立即提供满意的镇痛效果,并降低寒战发生率,且无任何严重副作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d8b1/5912223/271b2ebaf4e5/cjim-9-151-g001.jpg

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